Treatment of irritable bowel syndrome with a novel colonic irrigation system: a pilot study

• Published in: Techniques in coloproctology Vol. 20; no. 8; pp. 551 - 557
• Main Authors: Hsu, H.-H., Leung, W.-H., Hu, G.-C.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.08.2016; Springer Nature B.V
• Subjects: Abdominal Pain - etiology; Abdominal Surgery; Adult; Colon; Colorectal Surgery; Constipation - etiology; Defecation; Diarrhea - etiology; Feces; Female; Gastroenterology; Humans; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Original; Original Article; Patient Satisfaction; Pilot Projects; Proctology; Surgery; Symptom Assessment; Therapeutic Irrigation - instrumentation; Treatment Outcome; Young Adult; Ashong colonic irrigation apparatus; Colonic irrigation; Irritable bowel syndrome
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-016-1491-x

Background Medical treatments for irritable bowel syndrome (IBS) are often disappointing. A colonic irrigation system, the Ashong colonic irrigation apparatus (ACIA), was designed as a patient-administered device for defecation disorders. This pilot study evaluated the efficacy and safety of ACIA for IBS. Methods Eighteen patients, 12 with constipation-dominant IBS (IBS-C) and 6 with diarrhea-dominant IBS (IBS-D) group, were studied. Patients were randomized into treatments of 1–4 weeks. Colonic irrigation was performed twice daily for 6 consecutive days per week. To determine the response to treatment, bowel movement frequency, stool consistency, abdominal pain, patient satisfaction with bowel movements, and distress/discomfort due to symptoms were assessed. Results The scores of abdominal pain ( p  < 0.001), satisfaction ( p  < 0.001), and distress/discomfort ( p  < 0.001) improved significantly. The frequency of bowel movements in the IBS-C group increased from 1.68 to 3.78 times per week ( p  < 0.001). The occurrence of Bristol Stool Scale type 1 and 2 stool passage decreased from 45 to 13 % ( p  = 0.009) in the IBS-C group and type 6 and 7 stools decreased from 62 to 28 % ( p  = 0.005) in the IBS-D group. Only mild adverse events occurred, and all patients completed treatment. Conclusions Colonic irrigation with ACIA is safe and can improve abdominal pain, constipation, and diarrhea associated with IBS. Patients were more satisfied with their bowel movements and found their symptoms were less disturbing. Larger studies on long-term efficacy and quality of life and on placebo effects are needed.